Research on the effects of diaphragm relaxation technique combined with resistance breathing training on motor ability of stroke survivors

doi:10.3969/j.issn.1004-583X.2023.11.007

Abstract

Abstract:

Objective To explore the effects of diaphragm relaxation technique combined with resistance breathing training on motor ability of stroke survivors. Methods A total of 60 patients with cerebral apoplexy in the Rehabilitation Department of Zhengzhou Central Hospital were randomly divided into group A, group B and group C. Patients in Group A received routine rehabilitation training, diaphragm relaxation and resistance breathing training; those in group B received routine rehabilitation training and diaphragm relaxation; and those in group C received routine rehabilitation training and resistance breathing training. Maximal inspiratory pressure, peak inspiratory velocity, Fugl-Meyer motor function assessment (FMA), 10-meter walking test (10MWT), Berg balance function (BBS), and limits of stability (LOS) of all subjects were evaluated before intervention and 4, 8, and 12 weeks after rehabilitation training. Statistical data were analyzed. Results Before experiment intervention, there were no significant differences in MIP, PIF, FMA, 10MWT, BBS and LOS among group A, B and C ( $P$ >0.05). After experiment intervention, MIP, PIF, FMA, BBS and LOS in groups A, B and C significantly increased ( $P$ <0.05), but 10MWT significantly decreased at 4, 8 and 12 weeks compared with those before the experimental intervention ( $P$ <0.05). After experiment intervention, there were significant differences in the MIP, PIF, FMA, 10MWT, BBS and LOS at 4, 8 and 12 weeks among group A, B and C ( $P$ <0.05). MIP, PIF, FMA, BBS and LOS of group A were significantly higher than those of group B and C, while 10MWT was significantly lower ( $P$ <0.05). MIP, PIF, FMA, BBS and LOS of group C were significantly higher than those of group B, but 10MWT of group C was significantly lower than that of group B ( $P$ <0.05). Conclusion Diaphragm relaxation technique combined with resistance breathing training has better healing effects than the single training. Diaphragm relaxation technique can be extended as a choice of home rehabilitation exercise for stroke patients.

Key words: stroke, diaphragm relaxation, breathing training, motor ability

CLC Number:

R743.3

Yu Yifu, Yuan Chunhua. Research on the effects of diaphragm relaxation technique combined with resistance breathing training on motor ability of stroke survivors[J]. Clinical Focus, 2023, 38(11): 1002-1007.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2023.11.007

https://huicui.hebmu.edu.cn/EN/Y2023/V38/I11/1002

Figures/Tables 4

Tab.1 Comparison of general data between groups

组别	例数	年龄 (岁)	病程 (月)	BMI值 (kg/m²)	性别[例(%)]		偏瘫侧[例(%)]		疾病类型[例(%)]
组别	例数	年龄 (岁)	病程 (月)	BMI值 (kg/m²)	男	女	左侧	右侧	脑出血	脑梗死
A组	20	50.95±6.63	4.33±1.30	23.65±2.35	13(65.0)	7(35.0)	12(60.0)	8(40.0)	6(30.0)	14(70.0)
B组	19	47.32±4.27	4.42±1.39	24.63±2.40	11(57.9)	8(42.1)	10(52.6)	9(47.4)	5(26.3)	14(73.7)
C组	19	49.43±5.83	3.87±1.21	22.83±2.62	12(63.2)	7(36.8)	11(57.9)	8(42.1)	6(31.6)	13(68.4)
χ²/ $F$ 值		2.083	0.982	2.563	0.219		0.223		0.132
$P$ 值		0.134	0.381	0.086	0.896		0.894		0.936

Tab.1 Comparison of general data between groups

组别	例数	年龄 (岁)	病程 (月)	BMI值 (kg/m²)	性别[例(%)]		偏瘫侧[例(%)]		疾病类型[例(%)]
组别	例数	年龄 (岁)	病程 (月)	BMI值 (kg/m²)	男	女	左侧	右侧	脑出血	脑梗死
A组	20	50.95±6.63	4.33±1.30	23.65±2.35	13(65.0)	7(35.0)	12(60.0)	8(40.0)	6(30.0)	14(70.0)
B组	19	47.32±4.27	4.42±1.39	24.63±2.40	11(57.9)	8(42.1)	10(52.6)	9(47.4)	5(26.3)	14(73.7)
C组	19	49.43±5.83	3.87±1.21	22.83±2.62	12(63.2)	7(36.8)	11(57.9)	8(42.1)	6(31.6)	13(68.4)
χ²/ $F$ 值		2.083	0.982	2.563	0.219		0.223		0.132
$P$ 值		0.134	0.381	0.086	0.896		0.894		0.936

Tab.2 Comparison of inspiratory function between groups before and after intervention ( x -±s)

组别	例数	MIP(cmH₂O)				PIF(L/min)
组别	例数	0周	4周	8周	12周	0周	4周	8周	12周
A组	20	37.81±7.17	65.38±9.08^#	75.52±7.93^△	83.99±6.41^*#	1.97±0.51	3.51±0.74^#	4.25±0.82^△	4.90±0.73^*#
B组	19	38.74±7.01	53.79±7.72^#	62.22±7.27^△	67.67±6.11^*#	1.89±0.54	2.46±0.60^#	3.21±0.64^△	3.54±0.62^*#
C组	19	38.47±8.78	57.36±9.68^#	67.73±8.29^△	74.16±8.46^*#	1.99±0.62	2.94±0.66^#	3.97±0.72^△	4.30±0.76^*#
组间		$F$ =10.738 $P$ =0.000				$F$ =11.326 $P$ =0.000
时点间		$F$ =740.420 $P$ =0.000				$F$ =269.760 $P$ =0.000
组间·时点间		$F$ =11.534 $P$ =0.000				$F$ =9.497 $P$ =0.000

Tab.2 Comparison of inspiratory function between groups before and after intervention ( x -±s)

组别	例数	MIP(cmH₂O)				PIF(L/min)
组别	例数	0周	4周	8周	12周	0周	4周	8周	12周
A组	20	37.81±7.17	65.38±9.08^#	75.52±7.93^△	83.99±6.41^*#	1.97±0.51	3.51±0.74^#	4.25±0.82^△	4.90±0.73^*#
B组	19	38.74±7.01	53.79±7.72^#	62.22±7.27^△	67.67±6.11^*#	1.89±0.54	2.46±0.60^#	3.21±0.64^△	3.54±0.62^*#
C组	19	38.47±8.78	57.36±9.68^#	67.73±8.29^△	74.16±8.46^*#	1.99±0.62	2.94±0.66^#	3.97±0.72^△	4.30±0.76^*#
组间		$F$ =10.738 $P$ =0.000				$F$ =11.326 $P$ =0.000
时点间		$F$ =740.420 $P$ =0.000				$F$ =269.760 $P$ =0.000
组间·时点间		$F$ =11.534 $P$ =0.000				$F$ =9.497 $P$ =0.000

Tab.3 Comparison of motor function between groups before and after intervention ( x -±s)

组别	例数	FMA(分)				10MWT(s)
组别	例数	0周	4周	8周	12周	0周	4周	8周	12周
A组	20	43.55±6.07	57.25±5.09^#	64.25±5.17^△	69.30±5.49^*#	50.33±4.36	38.41±4.26^#	27.91±3.49^△	23.47±3.31^*#
B组	19	43.32±5.21	49.53±6.23^#	54.79±5.88^△	58.84±5.35^*#	48.74±4.52	42.28±4.55^#	35.86±3.51^△	31.36±3.52^*#
C组	19	46.05±5.12	54.21±5.48^#	59.68±4.74^△	63.47±4.94^*#	47.71±4.35	38.24±3.38^#	29.13±3.69^△	26.01±4.13^*#
组间		$F$ =10.794 $P$ =0.000				$F$ =14.640 $P$ =0.000
时点间		$F$ =581.769 $P$ =0.000				$F$ =436.637 $P$ =0.000
组间·时点间		$F$ =5.139 $P$ =0.007				$F$ =19.034 $P$ =0.000

Tab.3 Comparison of motor function between groups before and after intervention ( x -±s)

组别	例数	FMA(分)				10MWT(s)
组别	例数	0周	4周	8周	12周	0周	4周	8周	12周
A组	20	43.55±6.07	57.25±5.09^#	64.25±5.17^△	69.30±5.49^*#	50.33±4.36	38.41±4.26^#	27.91±3.49^△	23.47±3.31^*#
B组	19	43.32±5.21	49.53±6.23^#	54.79±5.88^△	58.84±5.35^*#	48.74±4.52	42.28±4.55^#	35.86±3.51^△	31.36±3.52^*#
C组	19	46.05±5.12	54.21±5.48^#	59.68±4.74^△	63.47±4.94^*#	47.71±4.35	38.24±3.38^#	29.13±3.69^△	26.01±4.13^*#
组间		$F$ =10.794 $P$ =0.000				$F$ =14.640 $P$ =0.000
时点间		$F$ =581.769 $P$ =0.000				$F$ =436.637 $P$ =0.000
组间·时点间		$F$ =5.139 $P$ =0.007				$F$ =19.034 $P$ =0.000

Tab.4 Comparison of balance function between groups before and after intervention ( x -±s)

组别	例数	BBS(分)				LOS
组别	例数	0周	4周	8周	12周	0周	4周	8周	12周
A组	20	27.75±2.57	35.55±1.93^#	41.05±2.44^△	44.75±2.15^*#	49.25±4.31	61.05±3.05^#	68.38±2.50^△	72.14±2.93^*#
B组	19	28.74±2.40	32.95±2.30^#	35.89±2.26^△	37.89±2.40^*#	47.39±3.54	55.69±2.90^#	61.74±2.77^△	64.82±2.34^*#
C组	19	29.05±2.53	34.26±2.28^#	38.47±2.04^△	41.21±2.68^*#	48.41±4.13	58.15±3.03^#	64.86±2.27^△	68.20±3.47^*#
组间		$F$ =14.379 $P$ =0.000				$F$ =53.370 $P$ =0.000
时点间		$F$ =500.719 $P$ =0.000				$F$ =502.927 $P$ =0.000
组间·时点间		$F$ =22.231 $P$ =0.000				$F$ =3.994 $P$ =0.017

Tab.4 Comparison of balance function between groups before and after intervention ( x -±s)

组别	例数	BBS(分)				LOS
组别	例数	0周	4周	8周	12周	0周	4周	8周	12周
A组	20	27.75±2.57	35.55±1.93^#	41.05±2.44^△	44.75±2.15^*#	49.25±4.31	61.05±3.05^#	68.38±2.50^△	72.14±2.93^*#
B组	19	28.74±2.40	32.95±2.30^#	35.89±2.26^△	37.89±2.40^*#	47.39±3.54	55.69±2.90^#	61.74±2.77^△	64.82±2.34^*#
C组	19	29.05±2.53	34.26±2.28^#	38.47±2.04^△	41.21±2.68^*#	48.41±4.13	58.15±3.03^#	64.86±2.27^△	68.20±3.47^*#
组间		$F$ =14.379 $P$ =0.000				$F$ =53.370 $P$ =0.000
时点间		$F$ =500.719 $P$ =0.000				$F$ =502.927 $P$ =0.000
组间·时点间		$F$ =22.231 $P$ =0.000				$F$ =3.994 $P$ =0.017

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